# Herpes Simplex Virus Reactivation and Candida glabrata Fungemia Following Short-Term Corticosteroids in a Patient With Septic Shock

## TL;DR

A patient developed herpes and fungal infections after short-term corticosteroid treatment for septic shock, highlighting the risk of immune suppression even with brief steroid use.

## Contribution

Demonstrates that short-term corticosteroids can lead to opportunistic infections in critically ill patients without chronic immunosuppression.

## Key findings

- HSV-1 reactivation and C. glabrata fungemia occurred after corticosteroid therapy in a septic shock patient.
- Infections were managed with acyclovir and micafungin despite no prolonged immunosuppression.
- The case emphasizes the need for vigilance regarding steroid-induced immune suppression in ICU settings.

## Abstract

Opportunistic infections such as herpes simplex virus type 1 (HSV-1) reactivation and Candida glabrata fungemia are traditionally associated with chronic or profound immunosuppression. However, emerging evidence indicates that even brief, high-dose corticosteroid therapy can transiently impair immune function and predispose critically ill patients to severe secondary infections. We present a case of a 52-year-old man with multiple comorbidities who developed HSV-1 dermatitis with gingivostomatitis and C. glabrata fungemia following a short course of corticosteroids administered for septic shock. The patient's HSV-1 dermatitis was treated with acyclovir, and C. glabrata fungemia was treated with micafungin. This dual infectious complication occurred despite the absence of prolonged immunosuppressive therapy or invasive mechanical ventilation. The case underscores the underrecognized immunosuppressive potential of short-term corticosteroids in the intensive care unit (ICU). It highlights the need for heightened clinical vigilance, especially in patients with predisposing factors such as diabetes, renal impairment, and recent surgical instrumentation.